| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.54 | $3,776.00 | $9,870.00 | |
Cigna
| Facility | $117.56 | $535.00 | $615.00 | |
Medcost
| Facility | $106.38 | $139.00 | $211.86 | |
United
| Facility | $100.00 | $1,138.00 | $3,585.00 |
Bx Lvr Ndl Done Purpose Tm Oth Major Px
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.54 | $3,776.00 | $9,870.00 | |
Cigna
| Facility | $117.56 | $535.00 | $615.00 | |
Medcost
| Facility | $106.38 | $139.00 | $211.86 | |
United
| Facility | $100.00 | $1,138.00 | $3,585.00 |